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Contact Information

KELLY J MATTILA, DPT
236 PONDEROSA CT
EUREKA, CA95503-5368
 Phone: 303-803-8644
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatrics

2251G0304X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for KELLY J MATTILA · (Female)

NPI Number 1861738833
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 12/20/2012
Last updated 12/20/2012 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • CO License # 10087
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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